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SHALOM J. KIEVAL, M.D., P.C.

SHALOM J. KIEVAL, M.D., P.C.

Company Details

Name:	SHALOM J. KIEVAL, M.D., P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	24 Jun 1999 (26 years ago)
Entity Number:	2391884
ZIP code:	12203
County:	Albany
Place of Formation:	New York
Address:	20 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, United States, 12203
Principal Address:	200 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, United States, 12203

Shares Details

Shares issued 1000

Share Par Value 0.01

Type PAR VALUE

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2023

141814470

2024-10-11

SHALOM J. KIEVAL, M.D., P.C.

26

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2022

141814470

2023-07-24

SHALOM J. KIEVAL, M.D., P.C.

24

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2021

141814470

2022-07-08

SHALOM J. KIEVAL, M.D., P.C.

25

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2020

141814470

2021-07-21

SHALOM J. KIEVAL, M.D., P.C.

24

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2019

141814470

2020-07-21

SHALOM J. KIEVAL, M.D., P.C.

23

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2018

141814470

2019-07-18

SHALOM J. KIEVAL, M.D., P.C.

18

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

SHALOM J. KIEVAL, M. D. , P. C. 401(K) PROFIT SHARING PLAN

2017

141814470

2018-06-12

SHALOM J. KIEVAL, M.D., P.C.

13

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2000-01-01
Business code	621111
Sponsor’s telephone number	5182181234
Plan sponsor’s address	13 SUNSET DRIVE, LATHAM, NY, 12110

DOS Process Agent

Name	Role	Address
SHALOM J KIEVAL	DOS Process Agent	20 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, United States, 12203

Chief Executive Officer

Name	Role	Address
SHALOM J KIEVAL	Chief Executive Officer	200 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, United States, 12203

History

Start date	End date	Type	Value
2023-06-01	2023-06-01	Address	200 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, 12203, USA (Type of address: Chief Executive Officer)
2015-05-29	2023-06-01	Address	200 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, 12203, USA (Type of address: Chief Executive Officer)
2015-05-29	2023-06-01	Address	20 GREAT OAKS BOULEVARD, SUITE 223, ALBANY, NY, 12203, USA (Type of address: Service of Process)
1999-06-24	2023-06-01	Shares	Share type: PAR VALUE, Number of shares: 1000, Par value: 0.01
1999-06-24	2015-05-29	Address	1365 WASHINGTON AVENUE, ALBANY, NY, 12206, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
230601000416	2023-06-01	BIENNIAL STATEMENT	2023-06-01
211026001242	2021-10-26	BIENNIAL STATEMENT	2021-10-26
150529002011	2015-05-29	BIENNIAL STATEMENT	2013-06-01
990624000129	1999-06-24	CERTIFICATE OF INCORPORATION	1999-06-24

Date of last update: 20 Jan 2025

Sources: New York Secretary of State